January 7, 2010

I already blogged about the evidence that Vitamin C supplementation may make us more insulin resistant and render exercise useless, but the bad news about vitamin supplementation just keeps pouring in.

Vitamin C supplementation, it turns out, is also associated with a higher rate of cataracts. This finding emerged in a long study of 24,593 women 49–83 years old from the Swedish Mammography Cohort who were followed from September 1997 to October 2005. Data about their supplement use was collected by questionnaire, and cataract extraction cases were identified by linkage to the cataract extraction registers in the geographical study area (where there is a public health system).

The study found that

Among women aged 65 years or more, vitamin C supplement use increased the risk of cataract by 38% (95% CI: 12%, 69%). Vitamin C use among hormone replacement therapy users compared with that among nonusers of supplements or of hormone replacement therapy was associated with a 56% increased risk of cataract (95% CI: 20%, 102%)

The authors speculate that the commercial addition of B vitamins to foods like cereal and bread may be harmful. In addition, they note that niacin is eliminated from they body by sweating, which casts an interesting light on why exercise might be helpful to people with diabetes.

Lots of Bad News About Statins

Moving on, hidden in a press release describing a study published in the journal, Ophthalmology, a study conducted to learn whether statins might decrease Age Related Macular Degeneration (AMD) is the news that statins not only don't prevent Age Related Macular Degeneration, a major cause of blindness, but

Statin users were at slightly higher risk than non-users for developing advanced AMD,

The answer to the question posted in the title of the Science Daily article, turns out to be a resounding "No!" But it takes awhile to figure that out. As is so distressingly common, you will read several paragraphs which make it sound as if low dose aspirin had a protective effect on AMD, only to run up to this phrase,

"Though not statistically significant, the WHS risk reduction is similar to the result of the only other large randomized trial on this question..."

Why do people who are supposed to be reputable scientists get away with making statements like this? Not statistically significant means, "Even after we played all the games we could with these statistics we had to admit our results could easily be attributed to chance."

When reporting the association between statin use and an increased risk of AMD the chief researcher struggles to ignore her finding:

Dr. Maguire said several factors may be masking a protective effect for statins, the most important being that most patients who take statins for CVD are also at high risk for AMD. Only a randomized controlled trial could reveal statins' impact on AMD in the wider population, but since so many elderly people take statins it could be difficult to recruit a control group

She then suggests that maybe a longer study would find the protective effect she couldn't find.

But her whole comment reeks of the religious belief that statins must be good for people. In view of this, the last sentence is particularly disturbing as it tells us that despite the publication of study after study that fails to find benefits for most older people in taking statins, so many older people are now taking them that it is impossible to find a control group who do not.

This also means we will have a tough time linking any rise in "Age Related" blindness to these drugs if in fact statins are contributing to the rise.

And if that doesn't depress you enough, another study found that two different statins have a disturbing impact on several proteins associated with dementia.

You rarely hear about the finding that statins can cause dementia, sometimes irreversibly, because of the saturation marketing for these drugs that has doctors and patients alike completely brainwashed, but it is well documented. You can find the citations to that documentation HERE.

Antidepressants Don't Work Better Than Placebo for Most Of Those Who Get Them

Tragic news for those of you who are reading this blog because you became insulin resistant after taking an SSRI antidepressant is the convincing finding that for people with mild and moderate depression, these antidepressants are no more effective than a placebo--i.e. a sugar pill.

Before you protest that they helped you, I want to define "severe depression" which is the only kind of depression the studies find these drugs apparently can help. If you were able to get up in the morning, get out of bed, make it to work or school, no matter how sad you felt, you did not have severe depression. Severe depression is the kind that ends up causing people to need hospitalization. I've seen it and it's very different from the mild condition that is so common--and so profitable to the people who market SSRIs.

What this study demonstrates is that even though people might attribute feeling better to the drugs, there is no evidence the drugs did anything more than make them think they should feel better. So if the pills helped you, so would laying on of hands, a sprinkle of fairy dust, expensive guga-guga extract from far off Wabutuland, or anything else you believed would have magical powers.

When a large study shows something works no better than a placebo, it means that it is worthless. Unfortunately, these worthless SSRI drugs make people fat, increase their insulin resistance, and may be a factor contributing to the so-called "obesity epidemic." If you need a placebo, go with something harmless like acupuncture, or fairy dust. SSRIs have very bad side effects.

And along with that bad news we get the even worse news is that one out of eight people who go to a doctor for help with depression are now being prescribed one of the highly dangerous antipsychotic medications which are known, for a fact, to cause diabetes.

These drugs are meant for people who are hearing voices and are unable to function without them. For them, the choice of living with diabetes or schizophrenia may be an easy one. But the drug companies are marketing these powerful antipsychotics to family doctors who have no idea how to use them appropriately and they are producing a new generation of diabetics.

That's enough bad news for now. I'm going to have discuss the new marketing efforts being employed to convince doctors that weight loss surgery, despite its significant risk of death, is an appropriate cure for people with diabetes no matter what they weigh. But not yet.

16
comments:

Wow, thanks for the info! That's very interesting about niacin, because it's often the treatment given to raise HDL numbers for people who've tried the diet/exercise route. In my case, I managed to get all of my triglycerides, LDL, and overall cholesterol numbers in range, but HDLs dropped, too. Go figure. Luckily, my doctor is still in the watch-and-see stage with adding medication...she knows I'd rather not add yet another pill to my regimen.

"Pathophysiological mechanisms of cataract formation include deficient glutathione levels contributing to a faulty antioxidant defense system within the lens of the eye. Nutrients to increase glutathione levels and activity include lipoic acid, vitamins E and C, and selenium."

also

"Diabetic cataracts are caused by an elevation of polyols within the lens of the eye catalyzed by the enzyme aldose reductase."

Gyan, I am keeping a close eye on the Vitamin D research. The current enthusiasm for it it too reminiscent of the enthusiasm for other simplistic solutions that proved useless or dangerous.

So far, while there is lots of evidence that people with inflammatory conditions are low in Vitamin D there is no proof that supplementing with it reverses the conditions. It may be the symptom not the cause.

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Nigel, The Natural Cures article you cite is merely a discussion of theory not a study proving the effectiveness. If it cites evidence re antioxidants they ar probably small studies run by those with something to sell. The data in this large population study looks pretty convincing, especially when every other large population study of Vitamin C has found it increases mortality or does nothing.

The mechanism by which sorbitol damages the eye is complex and the polyol produced by chemical reactions that occur within the eye unrelated to dietary intake.

It is quite possible that "diabetics" as usual should be translated to "people with dangerously high blood sugars" but whether the dietary change reverses all the effects of years of exposure to high blood sugar is unknown.

The overwhelming data on supplements seems to be they are useless or dangerous. Get your micronutrients from food.

Cheers, Jenny. Regarding Vitamin D3, I supplement with 5,000iu/day which seems like a lot (compared to the RDA of 400iu/day) but, compared to the ~10,000iu/day we get from sensible sun-bathing, it's not.

I read your blog because I was a gnat's whisker away from a diagnosis of type 2 diabetes in 2003. I'm fine now, even though my weight hasn't changed and I haven't changed the amount of exercise I get, which isn't much.

That's very good to hear. I don't hear much along those lines, though, so it would be nice to understand exactly what the mechanism was.

The first few days I took Vitamin D I was hypoing, then that stopped and since then nothing else has happened to my blood sugar response. The good news, is that it isn't different from what it was 12 years ago either, probably due to carb restriction and that I use insulin with meals over about 10 g.

I believe that I had an insulin resistant liver churning out glucose and insulin resistant muscle & fat cells not taking in glucose very well.

I don't yet know how it works (I've just ordered a book on Medical Biochemistry which may or may not help - see my latest blog post for details) but it looks as though Vitamin D3 5,000iu/day has normalised the insulin sensitivity of my liver, muscle & fat cells.

The problem with the texts is that in the field of metabolism there is a lot that is stated as fact that isn't backed up by good quality research, and a TON of information based on rodents that doesn't necessarily carry over to humans. You'll read a lot about high fat diets causing IR, for example, based on mouse studies where mice are fed high carb/high fat diets. Mice metabolize fat differently than humans, too.

I have very little insulin resistance and intact fasting blood sugar control. I just don't produce insulin in response to rising glucose. I can get IR if I let my blood sugars stay over 180 for a long time, but so can anyone else.

Unfortunately, Vit D3 can't fix broken beta cells. It's good for lots of other things though. Ted Hutchinson got me started on the stuff at the beginning of 2007 for mental faculty reasons. As 5,000iu/day only costs ~3p/day (~4c/day), I shall supplement for the rest of my life. It looks like Linus Pauling got it wrong by one letter.Nige.

Re: depression. Again, I'm going to have to inform you that depression is a physically real condition. Be glad you do not have it.

In november I was often crying, felt moribidly depressed, my body ached. I felt tired. My motivation was non-existent. I couldn't remember things and my thinking was suckier. It was getting to the point where I really felt I was hanging on the edge... a little worse, I wouldn't be able to function. It was like being sick and in pain.

I started using light box in december. The first day I had a burst of huge energy.The next few days I progressively got better and better.Now in early jan, I feel fabulous. Tons of energy, sleeping less, a lot of motivation, NO depression at all, no aches/pains. Feel extremely good about myself and my future, incapable of being depressed/hopeless as I was a few weeks ago. 180 degrees.

This could be random. But it's almost certainly not, as I rarely feel this way in winter (summer, yes sometimes, but not winter). It's the light, which seems to have affected my circadian rhythm/brain functions so that I am no longer depressed and am now quite the opposite - feeling rather good.

I don't know why you are so sure depression is a fake disease, or that drugs can't help it. I personally have never used depression medicine, but I have NO DOUBT what so ever that depression is a physically real disease. I have lived it my whole life. It's awful. Be glad this does not happen to you. It has nothing to do with what is or is not going on in my life. It is usually triggered randomly, or by things that affect my chemistry - e.g. light, warmth, sleep, food. (more light, more warmth, less sleep, less food, tend to boost mood/energy).

I respect the work you've done for diabetes but you are really going off the rails with your idea that depression is common/not a disease/not worthy of treating/etc.

Oh and by the way, proof that this is physically real is the fact even my *metabolism* seems to change in flux with my depressions. When I'm in the shit, I can't stop eating and gain weight rapidly. Now that I'm out of it, I find it very hard to gain weight... even if I eat the same, I don't gain weight. I seem to lose it easily. It's not entirely explained by food intake or activity. My insulin sensitivity/ability to use glucose is simply heaps better when I'm not depressed. I can actually eat carbs and feel normal, good.

The finding that depression goes hand in hand with fatness/IR is probably just as much effect of depression as it is related to drugs.

Let's also not forget that the traditional "melancholic depression" features profound anorexia/activation which will cause weight loss. The relationship between drugs and weight gain may be that many depressives will eat more when they are emotionally stable.Only the atypical depressives can expect to eat less/lose weight if they are stable.

I would NEVER say that depression isn't a real condition. I have had my share of it. What I am pointing out is that the drugs prescribed for it don't work better than sugar pills. Depression like many other conditions responds to placebos. In fact one third of depressions will clear up without medication and that turns out to be the cure rate for the SSRIs.

If you have two groups of people and in one 30% get better with no drug and in the other 30% get better taking a drug, a rational person (not earning profits from the drug) must conclude the drug is useless.

When the placebo has damaging side effects, it's a bad idea to use it.

I am an occasional reader of your blog and had not visited in months. I knew that beta carotene and vitamin E supplements could be harmful but had never heard anything negative about vitamin C until now. I'm not a big fan of supplements and take only a 1/2 teaspoon of cod liver oil daily along with krill oil, vitamin D3 and vitamin C. The krill oil and D pills are tiny and go down easy but the ester-C pill is huge. Now I have an excuse not to take it anymore! I see from an old post that you take vitamin D. What do you think of krill oil?

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I was diagnosed with diabetes in 1998. Since then I've kept my A1cs in the 5.0-6.0% range using the techniques you'll find explained at The main Blood Sugar 101 Web Site, where you'll also find extensive discussion of the peer-reviewed research that backs up the statements you read here.

I've also published two books on related subjects, Blood Sugar 101: What They Don't Tell You About Diabetes, which was an Amazon Diabetes bestseller for 3 years and Diet 101: The Truth About Low Carb Diets.